The goal of the Patient-Reported Outcomes Measurement Information System (PROMIS) is to develop an adaptive system for measuring outcomes in chronic diseases. The University of Pittsburgh has served as a PROMIS research site since 2004, focusing on the domains of emotional distress and sleep-wake function. We developed 5 PROMIS item banks (depression, anxiety, anger, sleep disturbance, and wake disturbance) of the 11 currently available. This renewal application will continue and extend our earlier work (a) by validating further the item banks we have developed using new samples, underrepresented groups (African Americans and older adults), and longitudinal analyses and (b) by developing new item banks in a complementary area of mental health-positive psychological functioning.
Our specific aims are (1) to validate further the PROMIS item banks for emotional distress by demonstrating the feasibility and value of CAT administration;by examining in a more definitive way differential item functioning (DIF) for race and age;and by establishing the greater sensitivity to change of the PROMIS measures compared to conventional legacy instruments in a high-risk population-geriatric patients with depression;(2) to validate further the PROMIS sleep disturbance and wake disturbance item banks with work on construct validity (comparing known groups with clinically diagnosed sleep disorders versus no sleep disorder);convergent and discriminant validity using other common retrospective, qualitative sleep-wake measures and prospective, quantitative assessments (sleep diaries, wrist actigraphy);and treatment responsiveness and minimal important differences by following patients with sleep disorders from initial evaluation through 6-8 weeks of treatment;(3) to examine longitudinal and reciprocal relationships between emotional distress and sleep-wake function by administering these banks prospectively in 4 waves over the course of 12 months to a sample of participants from the RAND American Life Panel;and (4) to develop new item banks to evaluate positive psychological functioning, an area of mental health in the PROMIS domain framework complementary to our work on emotional distress. In all studies, we propose to investigate the value of the comprehensive PROMIS health status profile (i.e., assessments across all 11 current PROMIS item banks) for identifying novel associations between domains and novel profiles of patients with chronic diseases. Our work will involve collaboration with various research groups within the University of Pittsburgh and across the country (RAND, Duke University, and LSU Health Sciences Center-Shreveport).

Public Health Relevance

Our proposed new studies will enhance the value and public health impact of PROMIS by including new samples of older adults and minority populations;examining the utility of PROMIS measures in applied treatment contexts;evaluating longitudinal relationships between the domains of mental health and sleep- wake function;utilizing CAT to maximize efficiency in real-world settings;and demonstrating the value of the overall health status profile that can be derived from all available PROMIS item banks.